AGEP Flashcards
incidence of AGEP per year
1-5/ million cases per year
Genetic predispositition of what genes have more assoc w AGEP.
HLA B51, DR11, DQ3.
lesions.
eruption evilves and disseminates rapidly. more than 100 non follicular pinpoint pustules less than 5mm.
Dermoscopy may aid in identifying pustules.
lab abnormality in AGEP.
Leukocytosis. Neutrophilia (90%)
eosinophilia (30%)
Freq implicated meds:
Antibiotics penicilline macrolide classes plus clindamycin minocycline sulfo antimycotic vanco quinolone antiepileptic antihypertensive CCB diltiazem hydroxychloroquine
steroid allopurino” oxicam nsaid pseudoephedrine terazosine omeprazole sennoside
Histo
early lesion- papillary edema; neurtrophil clusters in dermal ppillae and perivasc eosinophil.
AGEP TX
Most pxs- topical steroid, anti histamine
over 1/3 of cases, systemic corticosteroid may be req.
severe- Cyclosporine, infliximab, etanercept.
Immunologic urticaria is mst often assoc w what drugs
penicillin; and related B lact antibiotics.
known complicafion if acei and arbs.
Angioedema
Lisinopril and enalapril > captopril
most common drugs that cause photosensitivity reactions ( photosenstive drug reactions)
NSAID tmpsmz thiazide diuretixs sulfonylureas quinine quinidine phenothiazine tetracycline
NSAID freq assoc w photosensitivity
Piroxicam.
Histo
Spongiosis, exocytosis, perivasc inflamm cells
Which fluoroquinolone is highly photosensitizing
Sparfloxacin.
Mildly- enoxacin, ciprofloxafin; sitafloxacin.
drug rep to induce photoleukomelanoderma - a mosaic mix of hypo/ hyperpigmentTion after erythema in sun exposed areas.
Flutamide
% affected a voriconazole after more than 12 weeks intake/
8-10%
Photodistributed telangiectasis is a rare complicarion of whT drug class
CCB ( nifedipine, felodipine, amlodipine)
syndrome hase been seen w injection of many unrelated agents inc nsaid, loc anesthetic; steroi, antibiotic, ifn alpha, segatives vaccine MPA
Nicolau syndrome
3 types od hyperpigmentation in Minocycline.
1 - blue black discoloration. most common.
2- Appearancd of a similar colored pigmentatuon in the normal skin of the anterior shins.
In most cases type 1 and 2 minocycline pigmentation occur after 3 months to several yrs of tx. Histo: pigment granules in macrophages.
3- least coommon type. Generalized muddy brown hyperpigmentation accentuated on sun exposed areas.
minocycline also causes dental hyperpigmentatuon. midportion of the tooth.
The ff drugs all may cause blue black pigmentation of the face, extremities, cartilage, oral mucosa and nails i upto 29% of pxs.
Chloroquine, hydroxychloroquine, quinacrine.
drug cauaes photosensitivity in 30-57% of tx pxs in 3-6 mos. in 1-10% of pxs, slate gray hyperpigmentation dev in the areas of photosensitivity. pigmentation grad fades aftr med discontinued.
Histo PAS positive, yellow brown granules seen in cytoplasm of macrophage
Amiodarone
drug prod pink discoloration and hrad becomes reddishblue or brown. Histo: PAS positive, brown hranular pigment seen within foay macrophages.
“deug induced lipofucsinosis”
Clofazamine
blue or brown hyperpig most freq on nails.
zidovudine
most common heavy metal induced pigmentation by derma.
Silver.
deugs cause a slate gray hyperpig in sun exposed areas after long periods of ingestion
Chlorpromazine
thioridazine
imipramine
clomipramine
deug cause photodistributed hyprpig. most common in african american or hispanic women. and occurs after 1 yr after starting a tx. lesions are slate gray or gray blue macules and patches on the face, neck l, forearms. perifollicular accentuation.
CCB diltiazem
drugs that cauae serum sickness like rxn
cefaclor b lactM minocycline bupropion influenza vaccine nsaid rituximab
